Tetrabenazine: uses, dosing, side effects & brands
Tetrabenazine is a vesicular monoamine transporter 2 inhibitor sold in the U.S. under one brand, for huntington disease and hyperkinesis. Below: what the FDA label says, every product that contains it, what the pills look like, and its recall record.
Key facts
- Drug class
- Vesicular Monoamine Transporter 2 Inhibitor
- Treats
- Huntington Disease and Hyperkinesis
- Available as
- Tablet
- Sold as
- Xenazine
- Prescription?
- Prescription only
- Generic available?
- Not in our catalog
- What the pharmacy pays
- about $30 for a 30-count supply — not your price
- Boxed warning
- Boxed warning
How tetrabenazine is dosed
From the FDA label for Xenazine (application NDA021894). Other tetrabenazine products — different forms, different strengths — are dosed differently. Follow the label for the one you were prescribed.
Individualization of dose with careful weekly titration is required. The 1 st week's starting dose is 12.5 mg daily; 2 nd week, 25 mg (12.5 mg twice daily); then slowly titrate at weekly intervals by 12.5 mg to a tolerated dose that reduces chorea. ( 2.1 , 2.2 ) • Doses of 37.5 mg and up to 50 mg/day should be administered in three divided doses per day with a maximum recommended single dose not to exceed 25 mg. ( 2.2 ) • Patients requiring doses above 50 mg/day should be genotyped for the drug metabolizing enzyme CYP2D6 to determine if the patient is a poor metabolizer (PM) or an extensive metabolizer (EM). ( 2.2 , 5.3 ) • Maximum daily dose in PMs: 50 mg with a maximum single dose of 25 mg ( 2.2 ) • Maximum daily dose in EMs and intermediate metabolizers (IMs): 100 mg with a maximum single dose of 37.5 mg ( 2.2 ) • If serious adverse reactions occur, titration should be stopped and the dose should be reduced. If the adverse reaction(s) do not resolve, consider withdrawal of tetrabenazine tablets. ( 2.2 ) 2.1 General Dosing Considerations The chronic daily dose of tetrabenazine tablets used to treat chorea associated with Huntington's disease (HD) is determined individually for each patient. When first prescribed, tetrabenazine tablets therapy should be titrated slowly over several weeks to identify a dose of tetrabenazine tablets that reduces chorea and is tolerated.…
Tetrabenazine side effects
The following serious adverse reactions are described below and elsewhere in the labeling: • Depression and Suicidality [see Warnings and Precautions (5.1) ] • Neuroleptic Malignant Syndrome (NMS) [see Warnings and Precautions (5.4) ] • Akathisia, Restlessness, and Agitation [see Warnings and Precautions (5.5) ] • Parkinsonism [see Warnings and Precautions (5.6) ] • Sedation and Somnolence [see Warnings and Precautions (5.7) ] • QTc Prolongation [see Warnings and Precautions (5.8) ] • Hypotension and Orthostatic Hypotension [see Warnings and Precautions (5.9) ] • Hyperprolactinemia [see Warnings and Precautions (5.10) ] • Binding to Melanin-Containing Tissues [see Warnings and Precautions (5.11) ] Most common adverse reactions (greater than 10% and at least 5% greater than placebo) were: sedation/somnolence, fatigue, insomnia, depression, akathisia, anxiety/anxiety aggravated, nausea. ( 6.1 ) To report SUSPECTED ADVERSE REACTIONS, contact Oceanside Pharmaceuticals at 1-800-321-4576 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. 6.1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. During its development, tetrabenazine tablets were…
Who shouldn’t take tetrabenazine
Tetrabenazine tablets are contraindicated in patients: • Who are actively suicidal, or in patients with untreated or inadequately treated depression [see Warnings and Precautions (5.1) ]. • With hepatic impairment [see Use in Specific Populations (8.6) , Clinical Pharmacology (12.3) ]. • Taking monoamine oxidase inhibitors (MAOIs). Tetrabenazine tablets should not be used in combination with an MAOI, or within a minimum of 14 days of discontinuing therapy with an MAOI [see Drug Interactions ( 7.3 )]. • Taking reserpine. At least 20 days should elapse after stopping reserpine before starting tetrabenazine tablets [see Drug Interactions (7.2) ] . • Taking deutetrabenazine or valbenazine [see Drug Interactions ( 7.7 )] . • Actively suicidal, or who have depression which is untreated or undertreated ( 4 , 5.1 ) • Hepatic impairment ( 4 , 8.6 , 12.3 ) • Taking monoamine oxidase inhibitors (MAOIs) or reserpine ( 4 , 7.2 , 7.3 ) • Taking deutetrabenazine or valbenazine ( 4 , 7.7 )
Tetrabenazine drug interactions
7.1 Strong CYP2D6 Inhibitors In vitro studies indicate that α-HTBZ and β-HTBZ are substrates for CYP2D6. Strong CYP2D6 inhibitors (e.g., paroxetine, fluoxetine, quinidine) markedly increase exposure to these metabolites. A reduction in tetrabenazine tablets dose may be necessary when adding a strong CYP2D6 inhibitor (e.g., fluoxetine, paroxetine, quinidine) in patients maintained on a stable dose of tetrabenazine tablets. The daily dose of tetrabenazine should not exceed 50 mg/day and the maximum single dose of tetrabenazine tablets should not exceed 25 mg in patients taking strong CYP2D6 inhibitors [see Dosage and Administration (2.3) , Warnings and Precautions (5.3) , Use in Specific Populations ( 8.7 ), Clinical Pharmacology (12.3) ]. 7.2 Reserpine Reserpine binds irreversibly to VMAT2, and the duration of its effect is several days. Prescribers should wait for chorea to re-emerge before administering tetrabenazine tablets to avoid overdosage and major depletion of serotonin and norepinephrine in the CNS. At least 20 days should elapse after stopping reserpine before starting tetrabenazine tablets. Tetrabenazine tablets and reserpine should not be used concomitantly [see Contraindications (4) ]. 7.3 Monoamine Oxidase Inhibitors (MAOIs) Tetrabenazine tablets are contraindicated in patients taking MAOIs. Tetrabenazine tablets should not be used in combination with an MAOI, or within a minimum of 14 days of discontinuing therapy with an MAOI [see Contraindications (4) ]. 7.4 Alcohol or Other Sedating Drugs Concomitant use of alcohol or other sedating drugs may have additive effects and worsen sedation and somnolence [see Warnings and Precautions (5.7) ] . 7.5 Drugs That Cause QTc Prolongation Tetrabenazine tablets cause a small prolongation of QTc (about 8 msec), concomitant use with other drugs that are known to cause QTc prolongation should be avoided, these including antipsychotic medications (e.g., chlorpromazine, haloperidol, thioridazine, ziprasidone), antibiotics (e.g., moxifloxacin), Class 1A (e.g., quinidine, procainamide) and Class III (e.g., amiodarone, sotalol) antiarrhythmic medications or any other medications known to prolong the QTc interval. Tetrabenazine tablets should be avoided in patients with congenital long QT syndrome and in patients with a history of cardiac arrhythmias. Certain conditions may increase the risk for torsade de pointes or sudden death such as (1) bradycardia; (2) hypokalemia or hypomagnesemia; (3) concomitant use of other drugs that prolong the QTc interval; and (4) presence of congenital prolongation of the QT interval [see Warnings and Precautions ( 5.8 ), Clinical Pharmacology (12.2) ]. 7.6 Neuroleptic Drugs The risk for Parkinsonism, NMS, and akathisia may be increased by concomitant use of tetrabenazine tablets and dopamine antagonists or antipsychotics (e.g., chlorpromazine, haloperidol, olanzapine, risperidone, thioridazine, ziprasidone) [see Warnings and Precautions ( 5.4 , 5.5 , 5.6 )] . 7.7 Concomitant Deutetrabenazine or Valbenazine Tetrabenazine tablets are contraindicated in patients currently taking deutetrabenazine or valbenazine.
Every tetrabenazine product we track (1)
Same active ingredient — different manufacturer, form, price and FDA recall record. That last one is what our independent score measures.
Only one: Xenazine.
What tetrabenazine pills look like
Imprint codes, colour and shape from the FDA’s labelling data. Match the imprint on your pill — or search any imprint.
How long tetrabenazine keeps
No tetrabenazine label we read sets a separate limit for after opening, but they do specify how it must be stored — and the stability behind any date assumes those conditions.
Does tetrabenazine expire? The in-use limits and storage rules from its labelsWhat people report to the FDA about tetrabenazine
The FDA Adverse Event Reporting System (FAERS) collects reports from patients and clinicians. It holds 1,680 reports naming tetrabenazine, and the FDA flagged 79% of those reports as serious. The effects reported most often — leaving out reports about overdose, misuse or the condition being treated, which dominate the raw list for common medicines:
- tardive dyskinesia116 reports
- dystonia85 reports
- depression83 reports
- somnolence74 reports
- parkinsonism72 reports
- dyskinesia71 reports
- fall70 reports
- anxiety56 reports
Read these as a signal, not a rate. A report does not mean tetrabenazine caused the effect — anyone can file one, and many describe people taking several medicines for several conditions. Crucially there is no denominator: FAERS does not record how many people took the drug, so these counts cannot be turned into “X% of patients” — a bigger number often just means a more widely used or more talked-about drug. Duplicates exist, and publicity drives reporting. For what is actually established, read the FDA label section above.
Source: openFDA drug/event (FAERS), retrieved July 26, 2026.
Related calculators
Frequently asked questions
What is tetrabenazine?
Xenazine (Tetrabenazine) is a vesicular monoamine transporter 2 inhibitor used to treat Huntington Disease, Hyperkinesis.
What kind of drug is tetrabenazine?
The FDA classifies tetrabenazine as a vesicular monoamine transporter 2 inhibitor. If you are checking whether it is safe to combine with something else, the class is what matters — two drugs from the same class usually should not be stacked.
Can you take tetrabenazine with other medicines?
It depends on the medicine. We check it against the FDA labels rather than guessing: our interaction checker searches each drug's own label for the other and quotes what it says, naming the section it came from. Run tetrabenazine against whatever else you take — and remember that a label not naming a drug is not the same as that combination being safe.
What forms does tetrabenazine come in?
Across the brands we track, tetrabenazine is currently marketed as tablet, per the FDA's National Drug Code Directory. Each form is dosed differently — follow the label for the exact product you were prescribed.
Is there a generic tetrabenazine?
We do not currently list a generic-labelled tetrabenazine product. That does not always mean none exists — it means none appears under a generic name in the FDA data we track. Ask your pharmacist.
Cite this page
- APA
- pharmaranks. (2026, July 24). Tetrabenazine: uses, dosing, side effects & brands. https://pharmaranks.com/drugs/tetrabenazine
- MLA
- “Tetrabenazine: uses, dosing, side effects & brands.” pharmaranks, 24 July 2026, https://pharmaranks.com/drugs/tetrabenazine.
We summarise public FDA and NIH sources — for a clinical claim, cite the primary source we link to as well.
Sources: FDA openFDA drug label, National Drug Code Directory, and Enforcement (recall) database. This page reproduces public FDA data and is not medical advice. Dosing is set by your prescriber.
Read the full FDA label for tetrabenazine on DailyMed (NIH) ↗ — including its boxed warning in full.